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Miss Student is a 22-year-old female with asthma, diagnosed…

Miss Student is a 22-year-old female with asthma, diagnosed at the age of 9. She has been well maintained on inhaled corticosteroid for several years along with prn use of her albuterol inhaler.  During a recent office visit, you discover that her condition is not well controlled. Based on GINA guidelines, what would not be an appropriate next step in her pharmacologic management?

An adult male comes to the clinic with complaints that he is…

An adult male comes to the clinic with complaints that he is experiencing increased difficulty breathing over the past few days. He has a history of asthma and coronary artery disease. He was recently diagnosed with hypertension and started on propranolol, a non-selective beta blocker. Examination reveals no jugular vein distention and no productive cough. Breath sounds are present, but expiratory wheezes are noted bilaterally, and he denies any chest pain. His vital signs are pulse of 82 beats/min, respirations of 34 breaths/min, and BP of 170/100 mm Hg. His current medications are albuterol (Proventil) inhaler 2 puffs every 4 hours prn for wheezing, nitroglycerin transdermal patch for coronary artery disease, and propranolol 60 mg PO bid for his hypertension. He denies any medication allergies.  What is the best treatment for this patient?